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The influence of age on reproductive outcome in preimplantation genetic diagnosis (PGD)
Tijdschriftbijdrage - Tijdschriftartikel Conferentiebijdrage
OBJECTIVE: The aim of this study was to compare the pregnancy outcome in PGD cycles between different group of ages and to estimate the maximum female age at which clinical application of these techniques can be considered useful.
DESIGN: Prospective observational study.
MATERIALS AND METHODS: Between 1993-2005, the relationship between patient age and pregnancy outcome was assessed at a large academic referral centre for PGD. Subgroup analysis was performed between age groups per 5 years. Bivariate analysis (T-test) was used to determine the effect of age on clinical, ongoing and live birth delivery rate per oocyte collection cycle (OCC). Kaplan-Meier analysis of cumulative live birth delivery rate was used and Cox regression analysis was performed for the effect of age on cumulative outcome.
RESULTS: During 9 years, a total of 2753 cycles of PGD for monogenic disorders, numerical and structural chromosomal abnormalities (1453) and preimplantation genetic screening for aneuploidy (PGS) (1300) on 1498 patients were performed, resulting in the birth of 583 children. Based on Kaplan-Meier analysis the observed cumulative delivery rate was 29% vs 64% expected cumulative delivery rate. Our Cox regression analysis model demonstrates that the effect of age on cumulative live birth delivery rate is highly significant (p
CONCLUSIONS: Age has a significantly negative effect on reproductive outcome in PGD especially over the age of 40. Mode of inheritance, fertility status and type of ovarian stimulation protocol does not influence success rates in PGD.
DESIGN: Prospective observational study.
MATERIALS AND METHODS: Between 1993-2005, the relationship between patient age and pregnancy outcome was assessed at a large academic referral centre for PGD. Subgroup analysis was performed between age groups per 5 years. Bivariate analysis (T-test) was used to determine the effect of age on clinical, ongoing and live birth delivery rate per oocyte collection cycle (OCC). Kaplan-Meier analysis of cumulative live birth delivery rate was used and Cox regression analysis was performed for the effect of age on cumulative outcome.
RESULTS: During 9 years, a total of 2753 cycles of PGD for monogenic disorders, numerical and structural chromosomal abnormalities (1453) and preimplantation genetic screening for aneuploidy (PGS) (1300) on 1498 patients were performed, resulting in the birth of 583 children. Based on Kaplan-Meier analysis the observed cumulative delivery rate was 29% vs 64% expected cumulative delivery rate. Our Cox regression analysis model demonstrates that the effect of age on cumulative live birth delivery rate is highly significant (p
CONCLUSIONS: Age has a significantly negative effect on reproductive outcome in PGD especially over the age of 40. Mode of inheritance, fertility status and type of ovarian stimulation protocol does not influence success rates in PGD.
Tijdschrift: Fertil. Steril.
ISSN: 0015-0282
Issue: September
Volume: 90
Pagina's: 305
Jaar van publicatie:2008
Trefwoorden:PGD